Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09118 | Date 02/01/2021 |
| Token No | SM/20-21/28969 02/01/2021 | Serial | 003 Last Visit: 22/04/2021 |
| Patient Name | Mr. SANATAN LAHA | Contact No | |
| Address | 81, SHITALATALA ROAD SERAMPORE , BAIDYABATI(M) | Age | 70 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||